Рostoperative scar endometriosis: relevance of the present time
DOI:
https://doi.org/10.15574/HW.2025.1(176).1722Keywords:
epithelial-mesenchymal endometriosis, postoperative scar endometriosis, extragenital endometriosis, womenAbstract
Рostoperative scar endometriosis (РSE) is extragenital endometriosis, develops in 0.03-1.5% of women after surgical interventions.
Aim - studying the problem of РSE and evaluating the tactics of managing this pathology in women for 5 years to improve and implement comprehensive treatment.
Materials and methods. An analysis of anamnestic and clinical data, examination and treatment of 46 women with РSE was carried out during 2020-2024.
Results. There was a 5-fold increase in the frequency of РSE from 2020 to 2024. Tumor-like formation was observed in the scar area in 46 (100%) women, pain in the scar area in 42 (91.3%) women; scar induration in 20 (43.5%) women; abnormal uterine bleeding in 11 (23.9%) women. 21 (45.7%) women with РSE had a hereditary predisposition; a high infectious index in 42 (91.3%) women and concomitant extragenital pathology in 17 (36.9%) women. 32 (69.6%) women had a history of artificial abortions, 7 (15.2%) had spontaneous abortions (electrovacuum aspiration 48.3%); 43 (93.4%) had a cesarean section. Among gynecological diseases: inflammation of the uterus and appendages in 19 (41.3%); cervical pathology in 15 (32.6%); infertility II in 8 (17.3%); appendage operations in 12 (26%) women. Clinical symptoms appeared after previous operations on average 3.2 years. 60.9% of women with РSE were operated on 2-4 years after the onset of complaints, which indicates untimely referral to a medical institution and late diagnosis. In 37% of women, the level of the tumor marker CA 125 is elevated (38.4 U/ml). The complexity of the operation depended on the duration of the appearance of РSE by the time of surgery. The longer the clinical manifestations of РSE, the more widespread the pathological process, which required the involvement of surgeons and urologists.
Conclusions. Predictors of РSE were identified: intrauterine operations, complicated heredity, chronic inflammation of the uterus and appendages, cervical pathology, induced abortions. A woman after surgery and histological confirmation of endometriosis of the scar requires observation by a gynecologist and therapy to prevent relapse.
The study was conducted in accordance with principles of the Declaration of Helsinki. Research protocol was approved by local ethics committee of the participating institution. Informed consent was obtained.
The authors declare no conflict of interest.
References
Agha RA, Franchi T, Sohrabi C, Mathew G, Kerwan A, Thoma A et al. (2020, Dec). The SCARE 2020 guideline: updating consensus Surgical CAse Report (SCARE) guidelines. Int J Surg. 84: 226-230. Epub 2020 Nov 9. https://doi.org/10.1016/j.ijsu.2020.10.034; PMid:33181358
Al Hoshan MS, Shaikh AA. (2023, Jul 7). A Classical Case of Cesarean Scar Endometriosis in a 35-Year-Old Woman Presenting with Cyclical Abdominal Pain: A Case Report. Am J Case Rep. 24: e940200. https://doi.org/10.12659/AJCR.940200; PMid:37415321 PMCid:PMC10332116
Bodard S, Razakamanantsoa L, Geevarghese R, O'Gorman J, Dohan A et al. (2024, Nov 22). Percutaneous cryoablation of abdominal wall endometriosis: a systematic literature review of safety and efficacy. Insights Imaging. 15(1): 282. https://doi.org/10.1186/s13244-024-01823-4; PMid:39576446 PMCid:PMC11584811
Carsote M, Terzea DC, Valea A, Gheorghisan-Galateanu AA. (2020). Abdominal wall endometriosis (a narrative review). International journal of medical sciences. 17(4): 536. https://doi.org/10.7150/ijms.38679; PMid:32174784 PMCid:PMC7053307
Davis DM, Rasheid SH, Boucher ZH, Burgueno-Vega DA, Molina MA. (2023, Sep). Endometrioma Within the Anterior Abdominal Wall Causing Cyclic Abdominal Pain. Am Surg. 89(9): 3911-3912. Epub 2023 May 13. https://doi.org/10.1177/00031348231175122; PMid:37177808
Ferrandina G, Palluzzi E, Fanfani F, Gentileschi S, Valentini AL et al. (2016). Endometriosis-associated clear cell carcinoma arising in caesarean section scar: a case report and review of the literature. World journal of surgical oncology. 14(1): 1-8. https://doi.org/10.1186/s12957-016-1054-7; PMid:27912770 PMCid:PMC5135835
Goel P, Sood SS, Dalal A; Romilla. (2005, Nov). Cesarean scar endometriosis - report of two cases. Indian J Med Sci. 59(11): 495-498. https://doi.org/10.4103/0019-5359.18967; PMid:16340149
Golyanovskiy ОV, Kluzko ІV, Gubar ІA, Kulchytsckyi DV. (2019). Postoperative scar endometriosis Health of woman. 1(137): 44-47. https://doi.org/10.15574/HW.2019.137.44
Gonzalez RH, Singh MS, Hamza SA. (2021). Cutaneous Endometriosis: A Case Report and Review of the Literature. The American Journal of Case Reports. 22: e932493-1. https://doi.org/10.12659/AJCR.932493
Gupta P, Gupta S. (2015, Dec). Scar Endometriosis: a Case Report with Literature Review. Acta Med Iran. 53(12): 793-795. PMID: 26749239.
Ince C, Wagner A, Rajakumar C. (2018). Abdominal wall endometriosis. Journal of obstetrics and gynaecology Canada: JOGC = Journal d'obstetrique et gynecologie du Canada: JOGC. 40(7): 859. https://doi.org/10.1016/j.jogc.2017.03.107; PMid:28606452
Kocher M, Hardie A, Schaefer A, McLaren T, Kovacs M. (2017). Cesarean-section scar endometrioma: a case report and review of the literature. Journal of radiology case reports. 11(12): 16. https://doi.org/10.3941/jrcr.v11i12.3178; PMid:29290906 PMCid:PMC5741084
Kurochka VV, Kirieieva IV. (2022). Endometrioz pisliaoperatsiinoho rubtsia. II Vseukrainska naukovo-praktychna konferentsiia z mizhnarodnoiu uchastiu «Priorytetni napriamy doslidzhen v naukovii ta osvitnii diialnosti: problemy ta perspektyvy» 12-13 zhovtnia 2022 roku Rivne, Ukraina: 222-230.
Malutan AM, Simon I, Ciortea R, Mocan-Hognogi RF, Dudea M, Mihu D. (2017). Surgical scar endometriosis: a series of 14 patients and brief review of literature. Clujul Med. 90(4): 411-415. Epub 2017 Oct 20. https://doi.org/10.15386/cjmed-743; PMid:29151790 PMCid:PMC5683831
Mao A, Rana HN, Steffler B, Figarola S. (2020, Aug 27). Post-Cesarean Section Abdominal Wall Endometrioma. Cureus. 12(8): e10088. PMID: 33005511; PMCID: PMC7522165. https://doi.org/10.7759/cureus.10088
Marras S, Pluchino N, Petignat P, Wenger JM, Ris F et al. (2019). Abdominal wall endometriosis: An 11-year retrospective observational cohort study. European Journal of Obstetrics & Gynecology and Reproductive Biology. X; 4: 100096. https://doi.org/10.1016/j.eurox.2019.100096; PMid:31650130 PMCid:PMC6804734
Moazeni-Bistgani M. (2013, Sep). Recommending Different Treatments as Preventive Measures against Incisional Endometrioma. J Family Reprod Health. 7(3): 105-108. PMID: 24971111; PMCID: PMC4064782.
Philip CA, Warembourg S, Dairien M, Lefevre C, Gelet A, Chavrier F et al. (2020, Sep). Transrectal high-intensity focused ultrasound (HIFU) for management of rectosigmoid deep infiltrating endometriosis: results of Phase-I clinical trial. Ultrasound Obstet Gynecol. 56(3): 431-442. https://doi.org/10.1002/uog.21937; PMid:31788875 PMCid:PMC7496183
Plotski A. (2019). Endometriosis of Postoperative Scar. Scars. Intech Open. Edited by Anca Chiriac. https://doi.org/10.5772/intechopen.88246
Rexhepi M, Asani LV, Mulaki L, Koprivnjak K, Azemi M. (2023, Dec 18). Abdominal Wall Endometriosis at the Cesarean Section Scar. Pril (Makedon Akad Nauk Umet Odd Med Nauki). 44(3): 121-126. https://doi.org/10.2478/prilozi-2023-0055; PMid:38109456
Sharmila V, Kamatham V, Shankaralingappa A. (2023, Oct-Dec). Abdominal scar endometriosis: A case report and review of literature. Indian J Pathol Microbiol. 66(4): 871-873. https://doi.org/10.4103/ijpm.ijpm_460_22; PMid:38084553
Tatli F, Gozeneli O, Uyanikoglu H, Uzunkoy A, Yalcın HC et al. (2018). The clinical characteristics and surgical approach of scar endometriosis: A case series of 14 women. Bosnian Journal of Basic Medical Sciences. 18(3): 275. https://doi.org/10.17305/bjbms.2018.2659; PMid:29285999 PMCid:PMC6087557
Uçar MG, Şanlıkan F, Göçmen A. (2015). Surgical treatment of scar endometriosis following cesarean section, a series of 12 cases. Indian Journal of Surgery. 77(2): 682-686. https://doi.org/10.1007/s12262-013-0978-1; PMid:26730088 PMCid:PMC4692860
Vellido-Cotelo R, Muñoz-González JL, Oliver-Pérez MR, de la Hera-Lázaro C, Almansa-González C et al. (2015). Endometriosis node in gynaecologic scars: a study of 17 patients and the diagnostic considerations in clinical experience in tertiary care center. BMC women's health. 15(1): 1-10. https://doi.org/10.1186/s12905-015-0170-9; PMid:25783643 PMCid:PMC4337097
Yang E, Chen GD, Liao YH. (2023, Jan). Spontaneous abdominal wall endometriosis: A Case Report and review of the literature. Taiwan J Obstet Gynecol. 62(1): 155-157. https://doi.org/10.1016/j.tjog.2022.07.009; PMid:36720530
Zhang P, Sun Y, Zhang C, Yang Y, Zhang L, Wang N, Xu H. (2019). Cesarean scar endometriosis: presentation of 198 cases and literature review. BMC women's health. 19(1): 1-6. https://doi.org/10.1186/s12905-019-0711-8; PMid:30658623 PMCid:PMC6339338
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